Fig. 4

Prediction-guided prevention strategy for the risk of developing a “higher-than-normal BMI growth pattern” preceding overweight. “Higher-than-normal BMI growth pattern” defined as BMI z-score >1 SD [51] at least twice in relevant growth phases from 6 months to 5 years. ^aInitial risk quantification is performed at the 3-month well-child visit for “higher-than-normal BMI growth pattern” during the early phase (6 months to 2 years). ^bFirst risk re-assessment is performed at the 1-year visit for “higher-than-normal BMI growth pattern” during the late phase (3 to 5 years). ^cSecond risk re-assessment is performed at the 2-year visit for “higher-than-normal BMI growth pattern” during the late phase (3 to 5 years). ^dOverweight-preventive measures such as healthier complementary and family food choices, reduced screen time, increased physical activity, and a sleep duration of 10 to 14 h per day. If a risk score is above or equal to the respective cut-off score value (Table 2, Additional file 1: Table S4), the child is at risk of developing a “higher-than-normal BMI growth pattern,” and age-appropriate obesity-preventive measures should be initiated by the pediatrician. BMI, body mass index; h, hours; m, months; y, year(s)